Esophageal Cancer

Risk factors, symptoms, and treatment options for esophageal cancer.

The esophagus is the tube that carries food from the throat to the stomach. Esophageal cancer can start anywhere along the esophagus, but it occurs most often in the lower portion.

Esophageal cancer often is not diagnosed until it is in an advanced stage. Our digestive and thoracic cancer specialists combine a team approach with technology to develop a personalized treatment plan that offers the best long-term outcome. We are among only a handful of hospitals in the country that perform robot-assisted esophagectomy, surgery to remove a tumor as well as part of the esophagus. We also have surgeons experienced in colonic interposition (using part of the rectum to reconstruct the esophagus after surgery).

This disease and some treatments can make swallowing difficult or impossible. We offer palliative treatment options to minimize discomfort and improve quality of life.

Risk factors for esophageal cancer

Anyone can get esophageal cancer, but some risk factors include:

• Being older than 55
• Being male
• Heavy alcohol use
• Smoking or using chewing tobacco
• Having any of the following conditions:
  • Achalasia (failure of the esophageal sphincter to relax)
  • Barrett’s esophagus
  • Bile reflux
  • Gastroesophageal reflux disease (GERD)
  • Head and neck cancers

Types of esophageal cancer

There are two main types of esophageal cancer:

• Adenocarcinoma: This is the most common form of esophageal cancer. It typically affects the glands in the lower portion of the esophagus.
• Squamous cell carcinoma: This form of esophageal cancer affects the cells lining the middle portion of the esophagus.

Symptoms of esophageal cancer

Unfortunately, esophageal cancer symptoms may not be noticeable until the disease is advanced. Symptoms may include:

• Difficulty swallowing, or a choking sensation when eating
• Heartburn
• Indigestion
• Chest pain or pressure
• Unexplained weight loss

Treatment options for esophageal cancer

The doctor may recommend one or more treatments depending on the type of esophageal cancer and your health and personal preferences. Treatment may include:

• Chemotherapy
• Esophagectomy
  • Colonic interposition (Use part of the rectum to reconstruct the esophagus after cancer surgery)
• Radiation therapy

We participate in a number of clinical trials, which allow patients access to medicines and treatment methods not yet available to the general public. Talk with the doctor about whether you may qualify for a clinical trial.

Palliative treatments for esophageal cancer care

The most common symptom of advanced esophageal cancer is difficulty or inability to swallow. This is due to the tumor obstructing the esophagus.

We offer a range of palliative treatments to minimize discomfort and make swallowing easier. Some of these options include:

• Dilating the narrowed esophagus with a tube that is passed through the mouth and then pulled out. This option provides short-term relief, and there is a risk of perforation (tearing a hole in the esophagus).
• Positioning metallic expandable stents (tubes) permanently in the esophagus. This procedure has a high risk of perforation, but relief lasts longer.
• Using a laser beam to heat and vaporize the tumor to gradually reopen the esophagus. This therapy is effective and relatively safe.
• Using photodynamic therapy (PDT) -- a substance to make tumors sensitive to a special kind of laser light. When the lining of the esophagus is exposed to this light, the targeted tumor is killed.
• Other techniques to destroy tumors, such as cryotherapy to freeze tumors, or injecting substances directly into the tumor.

We offer rehabilitation services to help you regain swallowing and eating functions. We also have counselors and support groups available to help you through treatment and recovery.